The politics of hospital closures are perilous. After recent fights over the closings of St. Vincent's in Manhattan and Long Island College Hospital in Brooklyn, Mount Sinai leaders wished to avoid creating the perception that a beloved community institution such as Beth Israel was closing.

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The problem for Sinai officials is that few are buying their story.

Local politicians released statements that could best be described as cautiously pessimistic.

The New York Times, the Wall Street Journal and NY1 News used the word “close” in headlines about Beth Israel's fate, prompting Sinai CEO Ken Davis to issue a second statement only hours after his first.

“Mount Sinai’s plan to transform Beth Israel hospital has been erroneously referred to as a closure by a number of news outlets,” Davis said. “This is inaccurate and we want to reassure the community that Mount Sinai Beth Israel remains open for business, and looks forward to continuing to provide healthcare for residents of the downtown community.”

Whether the machinations at Beth Israel should be described as a closure, as downsizing, or a recasting of health services is merely a question of semantics and may prove to be irrelevant.

Sinai intends to sell a large, century-old hospital building and replace it with a much smaller inpatient facility supplemented by outpatient centers and physician practices.

Persuading the public of the merits of the plan, no matter how financially prudent it may be, will not be easy in an era when many people equate hospitals with health care.

The politics are only part of the problem. If people begin to think that Beth Israel is about to close or diminish in some way, then they may choose care at another hospital. That will further reduce Beth Israel's already diminished revenue, and could jeopardize Sinai's long-term plan.

The question for Sinai officials is how much resistance they will face from local residents and politicians who are already wondering how a hospital that fills 60 percent of its 856 certified beds could be replaced with a 70-bed facility without disrupting services to the community.

“The planned reduction of licensed inpatient beds from 856 to 70 raises real questions about whether that is adequate capacity for the downtown community; what percentage of patients would need to be moved for appropriate treatment; and how Mount Sinai would expand the number of beds if that proved necessary,” said Councilman Dan Garodnick, whose district includes Beth Israel.

Mayor Bill de Blasio, whose office has been in discussion with Sinai for months and whose 2013 campaign was based in part on protecting hospitals from closing, has yet to take a firm stand, releasing a somewhat vague statement that leaves room for the mayor to later support or oppose the idea.

“New Yorkers must be able to get the right care they need at the right time,” de Blasio said in a statement. “Major decisions about the future of hospitals have been happening in this city for the past decade, too often based on no plan whatsoever and without a larger strategy in place, and that has to end. Today, this Administration works with communities to ensure that institutions like Mt. Sinai continue to provide the healthcare New Yorkers need, especially emergency care, mental health and substance abuse services. While it is good to see that layoffs of unionized staff will be avoided and some important investments made, Mt. Sinai must work with the community to ensure that the inpatient and emergency care needs of local residents are met.”

Asked if the plan for Beth Israel met those needs, a spokeswoman for de Blasio did not respond.

Davis has long sought the mayor's support, seeking to avoid the kind of fight that bogged down the closing of Long Island College Hospital.

Davis has already won the support of 1199 SEIU, the powerful health care union, by promising to retain all its employees at equal pay.

Non-union employees won't be so fortunate, but without 1199 acting as a catalyst, it will be harder for local residents to organize, protest and pressure the mayor.

In the meantime, Sinai officials are left to emphasize two points. The first is that they are spending $500 million on health care, which is meant to show their commitment, though not all of it will be spent in the immediate area and they intend to recoup that investment when they sell Beth Israel.

The second is that the community will be better served by this new arrangement, which is a crucial point for Sinai to make if it is to keep patients from fleeing.

"There will be no loss of services for the community at any point in this process," Davis said.

That he made such an assurance twice in one day only underscores how much he wants residents to believe it is true.